1
|
Ma E, Fukasawa M, Ohira T, Yasumura S, Suzuki T, Furuyama A, Kataoka M, Matsuzaki K, Sato M, Hosoya M. Lifestyle behaviour patterns in the prevention of type 2 diabetes mellitus: the Fukushima Health Database 2015-2020. Public Health 2023; 224:98-105. [PMID: 37742586 DOI: 10.1016/j.puhe.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/23/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES Lifestyle behaviours associated with the incidence of type 2 diabetes mellitus (T2DM) need further clarification using health insurance data. STUDY DESIGN This is a cohort study. METHODS In 2015, 193,246 participants aged 40-74 years attended the specific health checkups and were observed up to 2020 in Fukushima, Japan. Using the principal component analysis, we identified two patterns from ten lifestyle behaviour questions, namely, the "diet-smoking" pattern (including smoking, alcohol drinking, skipping breakfast, eating fast, late dinner, and snacking) and the "physical activity-sleep" pattern (including physical exercise, walking equivalent activity, walking fast, and sufficient sleep). Then, individual pattern scores were calculated; the higher the scores, the healthier the behaviours. RESULTS The accumulative incidence rate of T2DM was 630.5 in men and 391.9 in women per 100,000 person-years in an average of 4 years of follow-up. Adjusted for the demographic and cardiometabolic factors at the baseline, the hazard ratio (95% confidence interval) of the highest versus lowest quartile scores of the "diet-smoking" pattern for T2DM risk was 0.82 (0.72, 0.92; P for trend = 0.002) in men and 0.87 (0.76, 1·00; P for trend = 0.034) in women; that of the "physical activity-sleep" pattern was 0.92 (0.82, 1·04; P for trend = 0.0996) in men and 0.92 (0.80, 1·06; P for trend = 0.372) in women. The "physical activity-sleep" pattern showed a significant inverse association in non-overweight men. CONCLUSIONS Lifestyle behaviour associated with a healthy diet and lack of smoking may significantly lower the risk of T2DM in middle-aged Japanese adults.
Collapse
Affiliation(s)
- E Ma
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan.
| | - M Fukasawa
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan
| | - T Ohira
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
| | - S Yasumura
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan; Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - T Suzuki
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan; Department of Computer Science and Engineering, The University of Aizu, Fukushima 965-8580, Japan
| | - A Furuyama
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan
| | - M Kataoka
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - K Matsuzaki
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan
| | - M Sato
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan
| | - M Hosoya
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan; Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| |
Collapse
|
2
|
He L, Zheng W, Li Z, Chen L, Kong W, Zeng T. J-shape relationship between normal fasting plasma glucose and risk of type 2 diabetes in the general population: results from two cohort studies. J Transl Med 2023; 21:175. [PMID: 36872318 PMCID: PMC9985867 DOI: 10.1186/s12967-023-04006-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/16/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Previous studies have reported that high fasting plasma glucose (FPG), even that within the normal range, is associated with the risk of type 2 diabetes (T2D). Nevertheless, these findings are limited to specific populations. Thus, studies in the general population are imperative. METHODS This study included two cohorts comprising 204 640 individuals who underwent physical examinations at the Rich Healthcare Group present at 32 locations in 11 cities of China from 2010 to 2016 and 15 464 individuals who underwent physical tests at the Murakami Memorial Hospital in Japan. Cox regression, restricted cubic spline (RCS), Kaplan-Meier (KM) curves, and subgroup analysis were used to determine the relationship between FPG and T2D. Receiver operating characteristic (ROC) curves were used to evaluate the predictive power of FPG for T2D. RESULTS The mean age of the 220 104 participants (204 640 Chinese and 15 464 Japanese participants) was 41.8 years (41.7 years for the Chinese and 43.7 years for the Japanese participants). During follow-up, 2611 individuals developed T2D (2238 Chinese and 373 Japanese participants). The RCS demonstrated a J-shaped relationship between FPG and T2D risk, with inflexion points of 4.5 and 5.2 for the Chinese and Japanese populations, respectively. Multivariate-adjusted hazard ratio (HR) was 7.75 for FPG and T2D risk after the inflexion point (7.3 for Chinese and 21.13 for Japanese participants). CONCLUSIONS In general Chinese and Japanese populations, the normal baseline FPG range showed a J-shaped relationship with the risk of T2D. Baseline FPG levels help identify individuals at high risk of T2D and may enable early primary prevention to improve their outcomes.
Collapse
Affiliation(s)
- Linfeng He
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenbin Zheng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zeyu Li
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lu Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wen Kong
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tianshu Zeng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. .,Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, Hubei, China. .,Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| |
Collapse
|
3
|
Pires IGS, Silva e Souza JA, de Melo Bisneto AV, Passos XS, Carneiro CC. Clinical efficacy of stem-cell therapy on diabetes mellitus: A systematic review and meta-analysis. Transpl Immunol 2022; 75:101740. [DOI: 10.1016/j.trim.2022.101740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/12/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
|
4
|
Chen Y, Zhong Q, Luo J, Tang Y, Li M, Lin Q, Willey JA, Chen JL, Whittemore R, Guo J. The 6-Month Efficacy of an Intensive Lifestyle Modification Program on Type 2 Diabetes Risk Among Rural Women with Prior Gestational Diabetes Mellitus: a Cluster Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1156-1168. [PMID: 35773443 PMCID: PMC9489585 DOI: 10.1007/s11121-022-01392-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 12/08/2022]
Abstract
This study aimed to evaluate the efficacy of an intensive lifestyle modification program tailored to rural Chinese women with prior gestational diabetes mellitus compared with usual care. In a cluster randomized controlled trial, 16 towns (clusters) in two distinct rural areas in China were randomly selected (8 towns per district); and 320 women with prior gestational diabetes mellitus were recruited from these towns. With stratification for the two study districts, eight towns (160 women) were randomly assigned to the intervention group of a tailored intensive lifestyle modification program and 8 towns (160 women) to the control group. Process measures were collected on attendance, engagement, fidelity, and satisfaction. Primary efficacy outcomes included glycemic and weight-related outcomes, while secondary efficacy outcomes were behavioral outcomes and type 2 diabetes risk score, which were collected at baseline, 3-month, and 6-month follow-up. Generalized estimation equations were used to analyze the data. High attendance (72% of sessions), engagement (67% of interactive activities and group discussions), fidelity (98%), and satisfaction (92%) with the tailored intensive lifestyle modification program were achieved. There were significant reductions in fasting blood glucose, oral glucose tolerance test 2 h, waist circumference, and type 2 diabetes risk score of participants in the intervention group compared to the control group (p < .05). There was no significant intervention effect on body mass index or behavioral outcomes (p > .05). In this study, we demonstrate the successful efficacy of an Intensive Lifestyle Modification Program in reducing type 2 diabetes risk among younger women with prior gestational diabetes mellitus. This tailored program delivered by local healthcare providers is a promising approach for diabetes prevention in rural China, reducing health disparities in rural communities about diabetes prevention. Registered in the Chinese Clinical Trial Registry (ChiCTR2000037956) on 3rd Jan 2018.
Collapse
Affiliation(s)
- Yao Chen
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 410013, Hunan, China
| | - Qinyi Zhong
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 410013, Hunan, China
| | - Jiaxin Luo
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 410013, Hunan, China
| | - Yujia Tang
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 410013, Hunan, China
| | - Mingshu Li
- Xiangya School of Public Health, Central South University, Changsha, 410078, Hinan, China
| | - Qian Lin
- Xiangya School of Public Health, Central South University, Changsha, 410078, Hinan, China
| | - James Allen Willey
- Philip R. Lee Institute for Health Policy Research, University of California, San Francisco, San Francisco, CA, 94118, USA
| | - Jyu-Lin Chen
- School of Nursing, University of California, San Francisco, San Francisco, CA, 94118, USA
| | | | - Jia Guo
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 410013, Hunan, China.
| |
Collapse
|
5
|
Tan C, Li B, Xiao L, Zhang Y, Su Y, Ding N. A Prediction Model of the Incidence of Type 2 Diabetes in Individuals with Abdominal Obesity: Insights from the General Population. Diabetes Metab Syndr Obes 2022; 15:3555-3564. [PMID: 36411787 PMCID: PMC9675349 DOI: 10.2147/dmso.s386687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aimed to distinguish the risk factors for type 2 diabetes mellitus (T2DM) and construct a predictive model of T2DM in Japanese adults with abdominal obesity. METHODS This study was a post hoc analysis. A total of 2012 individuals with abdominal obesity were included and randomly divided into training and validation groups at 70% (n = 1518) and 30% (n = 494), respectively. The LASSO method was used to screen for risk variables for T2DM, and to construct a nomogram incorporating the selected risk factors in the training group. We used the C-index, calibration plot, decision curve analysis, and cumulative hazard analysis to test the discrimination, calibration and clinical significance of the nomogram. RESULTS In the training cohort, the C-index and receiver operating characteristic were 0.819 and the 95% CI was 0.776-0.858, with a specificity and sensitivity of 77% and 74.68%, respectively. In the validation cohort, the C-index was 0.853; sensitivity and specificity were 77.6% and 88.1%, respectively. The decision curve analysis showed that the model's prediction was effective and cumulative hazard analysis demonstrated that the high-risk score group was more likely to develop T2DM than the low-risk score group. CONCLUSION This nomogram may help clinicians screen abdominal obesity at a high risk for T2DM.
Collapse
Affiliation(s)
- Caixia Tan
- The Second Affiliated Hospital, Department of Emergency Medicine, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People’s Republic of China
| | - Bo Li
- The Second Affiliated Hospital, Department of Critical Care Medicine, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Lingzhi Xiao
- The Second Affiliated Hospital, Department of Emergency Medicine, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People’s Republic of China
| | - Yun Zhang
- The Second Affiliated Hospital, Department of Emergency Medicine, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People’s Republic of China
| | - Yingjie Su
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, People’s Republic of China
| | - Ning Ding
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, People’s Republic of China
- Correspondence: Ning Ding, Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, People’s Republic of China, Email
| |
Collapse
|
6
|
Eating Dinner Early Improves 24-h Blood Glucose Levels and Boosts Lipid Metabolism after Breakfast the Next Day: A Randomized Cross-Over Trial. Nutrients 2021; 13:nu13072424. [PMID: 34371933 PMCID: PMC8308587 DOI: 10.3390/nu13072424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 12/11/2022] Open
Abstract
Aim: To examine whether mild early time-restricted eating (eating dinner at 18:00 vs. at 21:00) improves 24-h blood glucose levels and postprandial lipid metabolism in healthy adults. Methods: Twelve participants (2 males and 10 females) were included in the study. In this 3-day (until the morning of day 3) randomized crossover study, two different conditions were tested: eating a late dinner (at 21:00) or an early dinner (at 18:00). During the experimental period, blood glucose levels were evaluated by each participant wearing a continuous blood glucose measuring device. Metabolic measurements were performed using the indirect calorimetry method on the morning of day 3. The study was conducted over three days; day 1 was excluded from the analysis to adjust for the effects of the previous day’s meal, and only data from the mornings of days 2 and 3 were used for the analysis. Results: Significant differences were observed in mean 24-h blood glucose levels on day 2 between the two groups (p = 0.034). There was a significant decrease in the postprandial respiratory quotient 30 min and 60 min after breakfast on day 3 in the early dinner group compared with the late dinner group (p < 0.05). Conclusion: Despite a difference of only 3 h, eating dinner early (at 18:00) has a positive effect on blood glucose level fluctuation and substrate oxidation compared with eating dinner late (at 21:00).
Collapse
|
7
|
Wang Z, Liu Z, He S. Fasting plasma glucose and risk of type 2 diabetes mellitus in a group of Chinese people with normoglycemia and without obesity. J Diabetes 2021; 13:601-602. [PMID: 33728817 DOI: 10.1111/1753-0407.13180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 02/05/2023] Open
Affiliation(s)
- Ziqiong Wang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zheng Liu
- Nursing Department, West China School of Nursing, West China Hospital of Sichuan University, Chengdu, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| |
Collapse
|
8
|
Kim YS, Park YM, Han KD, Yun JS, Ahn YB, Ko SH. Fasting glucose level and all-cause or cause-specific mortality in Korean adults: a nationwide cohort study. Korean J Intern Med 2021; 36:647-658. [PMID: 32623847 PMCID: PMC8137392 DOI: 10.3904/kjim.2019.355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/14/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS Although people with diabetes have been shown to have higher mortality than people without diabetes, there is a lack of data on the association between fasting glucose (FG) levels and cause-specific mortality rates in the general population. METHODS A total of 326,547 Korean adults over 20 years of age, who had received a health checkup between 2006 and 2008 were selected from the Korean National Health Insurance Service sample cohort dataset and followed until 2015. We estimated hazard ratios (HRs) of all-cause mortality and cause-specific mortality relative to various range of FG levels. All causes of death were classified according to International Classification of Diseases (ICD)-10 codes. RESULTS During follow-up (mean, 8.5 years), a total of 13,536 deaths (mortality rate 4.89/1,000 person-year) occurred; 4,916 deaths from cancer, 2,133 from cardiovascular disease, 762 from infectious disease, 199 from renal disease, and 5,526 from other causes. The overall mortality rate increased with an increase in FG category (HR, 1.78; 95% confidence interval, 1.65 to 1.92; in the ≥ 160 mg/dL). In addition, a J-shaped associations was found between FG levels and all-cause mortality after adjustment for age, sex, smoking, drinking, physical activity, body mass index, diabetes mellitus medication, hypertension, and dyslipidemia. In particular, the risk of cancer-mortality with high FG levels was increased for men but not women. CONCLUSION The risk of all-cause and cause-specific mortality showed the tendency to increase when the FG level was outside of the normal range, indicating a J-shaped relationship, in both men and women.
Collapse
Affiliation(s)
- Yi-Suk Kim
- Department of Anatomy Catholic Institute for Applied Anatomy, The Catholic University of Korea, Seoul, Korea
| | - Yong-Moon Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, USA
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Correspondence to Seung-Hyun Ko, M.D. Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea Tel: +82-31-249-8155 Fax: +82-31-253-8898 E-mail:
| |
Collapse
|
9
|
Intraindividual double-burden of anthropometric undernutrition and "metabolic obesity" in Indian children: a paradox that needs action. Eur J Clin Nutr 2021; 75:1205-1217. [PMID: 33893450 PMCID: PMC7612996 DOI: 10.1038/s41430-021-00916-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/04/2021] [Accepted: 03/29/2021] [Indexed: 12/16/2022]
Abstract
Background Intraindividual coexistence of anthropometrically defined undernutrition and “metabolic obesity”, characterised by presence of at least one abnormal cardiometabolic risk factor, is rarely investigated in young children and adolescents, particularly in Low-and-Middle-Income-Countries undergoing rapid nutrition transition. Methods Prevalence of biomarkers of metabolic obesity was related to anthropometric and socio-demographic characteristics in 5-19 years old participants from the population-based Comprehensive National Nutrition Survey in India (2016-2018). The biomarkers, serum lipid-profile (total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides), fasting glucose, and glycosylated hemoglobin (HbA1C), and all jointly were analysed in 22567, 23192, 25962 and 19143 participants, respectively. Results Overall (entire dataset), the prevalence of abnormalities was low (4.3-4.5%) for LDL and TC, intermediate for dysglycemia (10.9-16.1%), and high for HDL and triglycerides (21.725.8%). Proportions with ≥1 abnormal metabolic obesity biomarker(s) were 56.2% overall, 54.2% in thin (BMI-for-age <-2SD) and 59.3% in stunted (height-for-age <-2SD) participants. Comparable prevalence was evident in mild undernutrition (-1 to -2 SD). Clustering of two borderline abnormalities occurred in one-third, warranting active life-style interventions. Metabolic obesity prevalence increased with BMI-for-age. Among those with metabolic obesity, only 9% were overweight/obese (>1SD BMI-for-age). Among poor participants, triglyceride, glucose and HDL abnormalities were higher. Conclusions A paradoxical, counter-intuitive prevalence of metabolic obesity biomarker(s) exists in over half of anthropometrically undernourished and normal-weight Indian children and adolescents. There is a crucial need for commensurate investments to address overnutrition along with undernutrition. Nutritional status should be characterized through additional reliable biomarkers, instead of anthropometry alone.
Collapse
|
10
|
Cai XT, Ji LW, Liu SS, Wang MR, Heizhati M, Li NF. Derivation and Validation of a Prediction Model for Predicting the 5-Year Incidence of Type 2 Diabetes in Non-Obese Adults: A Population-Based Cohort Study. Diabetes Metab Syndr Obes 2021; 14:2087-2101. [PMID: 34007195 PMCID: PMC8123981 DOI: 10.2147/dmso.s304994] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/28/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The aim of this study was to derivate and validate a nomogram based on independent predictors to better evaluate the 5-year risk of T2D in non-obese adults. PATIENTS AND METHODS This is a historical cohort study from a collection of databases that included 12,940 non-obese participants without diabetes at baseline. All participants were randomised to a derivation cohort (n = 9651) and a validation cohort (n = 3289). In the derivation cohort, the least absolute shrinkage and selection operator (LASSO) regression model was used to determine the optimal risk factors for T2D. Multivariate Cox regression analysis was used to establish the nomogram of T2D prediction. The receiver operating characteristic (ROC) curve, C-index, calibration curve, and decision curve analysis were performed by 1000 bootstrap resamplings to evaluate the discrimination ability, calibration, and clinical practicability of the nomogram. RESULTS After LASSO regression analysis of the derivation cohort, it was found that age, fatty liver, γ-glutamyltranspeptidase, triglycerides, glycosylated hemoglobin A1c and fasting plasma glucose were risk predictors, which were integrated into the nomogram. The C-index of derivation cohort and validation cohort were 0.906 [95% confidence interval (CI), 0.878-0.934] and 0.837 (95% CI, 0.760-0.914), respectively. The AUC of 5-year T2D risk in the derivation cohort and validation cohort was 0.916 (95% CI, 0.889-0.943) and 0.829 (95% CI, 0.753-0.905), respectively. The calibration curve indicated that the predicted probability of nomogram is in good agreement with the actual probability. The decision curve analysis demonstrated that the predicted nomogram was clinically useful. CONCLUSION Our nomogram can be used as a reasonable, affordable, simple, and widely implemented tool to predict the 5-year risk of T2D in non-obese adults. With this model, early identification of high-risk individuals is helpful to timely intervene and reduce the risk of T2D in non-obese adults.
Collapse
Affiliation(s)
- Xin-Tian Cai
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, People’s Republic of China
| | - Li-Wei Ji
- Laboratory of Mitochondrial and Metabolism, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, People’s Republic of China
| | - Sha-Sha Liu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, People’s Republic of China
| | - Meng-Ru Wang
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, People’s Republic of China
| | - Mulalibieke Heizhati
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, People’s Republic of China
| | - Nan-Fang Li
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, People’s Republic of China
- Correspondence: Nan-Fang Li Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People’s Republic of ChinaTel +86 991 8564818 Email
| |
Collapse
|
11
|
Sull JW, Kim G, Jee SH. Association of MC4R (rs17782313) with diabetes and cardiovascular disease in Korean men and women. BMC MEDICAL GENETICS 2020; 21:160. [PMID: 32807123 PMCID: PMC7433161 DOI: 10.1186/s12881-020-01100-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 08/03/2020] [Indexed: 01/26/2023]
Abstract
Background Diabetes is mostly assessed by the fasting glucose level. Several studies reported that serum fasting glucose levels and cardiovascular disease are associated with MC4R. Methods A total of 4294 subjects participated in this study. There were 1810 subjects with cardiovascular disease among the 4294 subjects. We used multivariate linear regression models and multiple logistic regression analysis. Results Individuals with the TC/CC genotype had a 1.29-fold higher risk of diabetes than did those with the TT genotype when adjusting for age, sex, and BMI (OR, 1.29; 95% CI, 1.04–1.60). For healthy subjects, the association was significant in women (OR, 1.99; 95% CI, 1.01–3.93). Men with the TC/CC genotype had a 1.21-fold higher risk of cardiovascular disease than did those with the TT genotype when adjusting for age, sex, and BMI (OR, 1.21; 95% CI, 1.04–1.41). The relationship between MC4R and cardiovascular disease was stronger in lean men (OR, 1.40; 95% CI, 1.12–1.74, p = 0.0028) than in overweight men. Conclusions This study suggests that the rs17782313 SNP in MC4R is related to diabetes and the SNP is also associated with cardiovascular disease in lean men.
Collapse
Affiliation(s)
- Jae Woong Sull
- Department of Biomedical Laboratory Science, College of Health Sciences, Eulji University, Seongnam, Korea
| | - Gitae Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Eulji University, Seongnam, Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea.
| |
Collapse
|